INSEA – ten years of self-management for everyday life
Since 2014, the INSEA program has been supporting people with chronic diseases for successful self-management. After more than ten years, the National Coordination Office, which was previously funded by the Bosch Health Campus, is now being handed over to the German Self-Help Group Association (Deutsche Arbeitsgemeinschaft Selbsthilfegruppe e.V.). Participants in INSEA courses learn how to better manage everyday life with their illnesses. The effectiveness of the courses has been proven and their importance recognized.
Jogging provides a balance to Anja Gebauers everyday life and gives her new energy.
A note in the calendar is usually not enough for Anja Gebauer (*name changed) to remember an important appointment, date or birthday. The 34-year-old was diagnosed with attention deficit hyperactivity disorder (ADHD) two years ago. This neurological developmental disorder often manifests itself in great difficulty concentrating, strong impulsivity and pronounced physical restlessness.
For example, Anja Gebauer finds it very difficult to think about things if she has not visualized them. “I have to place my appointments and to-do lists in my home in such a way that they come into my view as often and directly as possible,” explains the teacher. For example, the first information for the day hangs in the bathroom cabinet, which she opens every morning. She finds it even easier to remember things with pictures.
That's why she has taken photos of her friends. To plan birthdays or dates, she takes the right picture from neatly labeled boxes and hangs it on the otherwise bare wall in her bright kitchen to remind her.
In the INSEA course, the participant has learned to structure her everyday life through action plans and to consciously plan activities that are good for her.
There are just a few pieces of paper stuck next to the fridge, one of which contains her self-designed plan of action for the week. For example, it says: “Go for a walk for at least 15 minutes every day and go to bed by 10 p.m. at the latest”. Or when she wants to prepare something for breakfast, lunch and dinner. “The action plans are the be-all and end-all for me. They help me to structure my everyday life and remember things that are good for me,” says the ADHD patient, who has difficulties setting priorities, not getting distracted and keeping to fixed times due to her condition. In an INSEA self-management course for chronically ill people at the Bosch Health Campus, she learned how to set realistic, achievable and concrete goals for her plans without stressing herself out.
Worldwide self-management program for the chronic deseases
INSEA stands for the “Initiative for Self-Management and Active Living” and is a German network founded in 2014 to implement the proven “Chronic Disease Self-Management Program”. Kate Lorig, professor of medicine at Stanford University in the USA, developed the program in 1994. Since then, chronically ill people in more than 20 countries around the world have learned to actively manage their illness, improve their quality of life and organize their everyday lives. The courses are aimed at people with different and multiple chronic illnesses, their relatives and friends. In Germany, in addition to the Bosch Health Campus, the Barmer health insurance company and the Swiss Careum Foundation also support the implementation of the courses, which are free of charge for participants.
“INSEA is not a program to treat a disease, but to help people help themselves. We provide those affected with various tools to help them live with their illness and manage their own everyday lives as well as possible,” emphasizes Gabriele Seidel, who has headed the National INSEA Coordination Office at Hannover Medical School for the past ten years. During this time, the network has created structures for the development, organization and management of the dissemination of the course programme. The number of locations at which self-help facilities and PORT centers (patient-oriented centers for primary and long-term care) funded by the Bosch Health Campus regularly offer INSEA courses has increased from two to nine - as face-to-face events, but also online and by telephone.
The content of the six-week courses, in which participants meet weekly, includes relaxation and mindfulness exercises that can be used to alleviate pain. The program also includes topics such as healthy, adequate sleep and a balanced diet, preparing for medical consultations and dealing with medication, as well as methods for decision-making. At the heart of the courses are the action plans, which participants use to practise setting themselves realistic goals each week and practising how to achieve them. Each of the two-and-a-half-hour meetings begins and ends with this.
Evaluations prove the effectiveness of INSEA
Each course is evaluated by the Hannover Medical School - and the results show that it works. “The program has been proven to lead to an improvement in physical and mental well-being, quality of life, medication management and communication with healthcare professionals. A reduction in visits to the doctor and hospital has also been proven,” says Gabriele Seidel. The effectiveness is also confirmed by the more than 3200 participants. Many of them report how they were able to use the tools they learned to break the vicious circle of pain, exhaustion, depression and social isolation that many chronically ill people experience. Regardless of whether they suffer from diabetes, cardiovascular or lung disease, cancer, rheumatism or depression.
Anja Gebauer was also able to make positive changes to her life with ADHD with the help of INSEA: “I've learned to be more relaxed and to take the things that give me the energy I need for my professional and private life seriously.” These include regular jogging and crafting, reading, drinking tea and relaxing on an acupressure mat. She also volunteers to bind bouquets of flowers for the weekly market in Reutlingen. “I just like to help and give something back,” says the teacher. That's why she can well imagine supporting the INSEA team as a course leader in the future. The program relies on a tandem to teach the content. At least one of the two trained course leaders is affected by a chronic illness themselves or has personal experience of it. “In this way, we create an exchange and help at eye level,” explains Gabriele Seidel.
All those involved are working on expanding the program even further in the future, establishing additional locations and are committed to ensuring that INSEA finds a permanent place in the healthcare system - so that as many people as possible can actively manage their disease with good self-management.